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1 – 10 of over 3000Care management is a central part of the current health and social care system, but the development of Self‐Directed Support raises significant questions about the future of this…
Abstract
Care management is a central part of the current health and social care system, but the development of Self‐Directed Support raises significant questions about the future of this function. Moreover, if the current design of the care management function is to change, then this will raise significant challenges and opportunities for those professionals who currently act as care managers. These changes may even allow social workers to return to a way of working that fits better with their professional ethos.
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Fiona Henderson, Kelly Hall, Audrey Mutongi and Geoff Whittam
This study aims to explore the opportunities and challenges Self-directed Support policy has presented to Scottish social enterprises, thereby increasing understanding of emerging…
Abstract
Purpose
This study aims to explore the opportunities and challenges Self-directed Support policy has presented to Scottish social enterprises, thereby increasing understanding of emerging social care markets arising from international policy-shifts towards empowering social care users to self-direct their care.
Design/methodology/approach
This study used guided conversations with a purposive sample of 19 stakeholders sampled from frontline social care social enterprises; social work; third sector; health; and government.
Findings
An inconsistent social care market has emerged across Scotland as a result of policy change, providing both opportunities and challenges for social enterprises. Social innovation emerged from a supportive partnership between the local authority and social enterprise in one area, but elsewhere local authorities remained change-resistant, evidencing path dependence. Challenges included the private sector “creaming” clients and geographic areas and social enterprises being scapegoated where the local market was failing.
Research limitations/implications
This study involved a small purposively sampled group of stakeholders specifically interested in social enterprise, and hence the findings are suggestive rather than conclusive.
Originality/value
This paper contributes to currently limited academic understanding of the contribution of social enterprise to emerging social care markets arising from the international policy-shifts. Through an historical institutionalism lens, this study also offers new insight into interactions between public institutions and social enterprise care providers. The insights from this paper will support policymakers and researchers to develop a more equitable, sustainable future for social care provision.
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A central element in the shift to a ‘personalised’ care system in the UK is the opportunity for disabled people to hold and manage budgets for the purchase of care and support, to…
Abstract
A central element in the shift to a ‘personalised’ care system in the UK is the opportunity for disabled people to hold and manage budgets for the purchase of care and support, to replace local authority services. The delivery mechanisms of ‘Direct Payments’ and ‘Individual Budgets’ have allowed many disabled people to control their care and support better, and have promoted their social inclusion. However, the particular contexts and issues for people with learning disabilities in holding personal funding have been little considered. The paper sets out the broad themes of the introduction of personalised care, and examines the limited use by people with learning disabilities of Direct Payments and the subsequent development of Individual Budgets. The paper considers the challenges to the nature, spaces and relations of care commonly used by people with learning disabilities that personal budgets present, in particular for those with more severe disabilities. The paper concludes by suggesting ways in which people with learning disabilities can use personal budgets, whilst maintaining the collective relations and spaces of caring desired by many.
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Rowan Jasper, Jane Hughes, Caroline Sutcliffe, Michele Abendstern, Niklas Loynes and David Challis
The provision of information and advice for older people arranging their own care is a policy objective. The purpose of this paper is to explore the range and scope of web-based…
Abstract
Purpose
The provision of information and advice for older people arranging their own care is a policy objective. The purpose of this paper is to explore the range and scope of web-based information about care coordination activities for older people in the non-statutory sector in England.
Design/methodology/approach
Non-statutory organisations were identified through a structured internet search. Services were screened to identify those providing at least one care coordination activity. A postal survey of services was conducted in 2014 and results compared with the initial findings of the web search.
Findings
Almost 300 services were identified, most of which were provided by three organisations: Age UK; Alzheimer’s Society; and the British Red Cross. Brokerage was the most frequently reported care coordination activity; the majority of services focussed on help to stay at home; and carers and older people (including those with dementia) were the target groups most often identified. Comparison of the two information sources revealed a significant agreement between two care coordination’s activities: compiling support plans and monitoring and review.
Research limitations/implications
Findings are based on a purposive sample of organisations and therefore care must be exercised in generalising from them.
Originality/value
This study is one of the first to systematically explore the nature and extent of information about care coordination activities provided by the non-statutory sector in England. It was conducted when policy advocated both an increased role for the non-statutory sector and an increase in self-directed support.
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This article presents plans to evaluate the individual budget pilots in England. The setting up of the 13 pilot projects is described, and the evaluation's questions and…
Abstract
This article presents plans to evaluate the individual budget pilots in England. The setting up of the 13 pilot projects is described, and the evaluation's questions and approaches are outlined. The article outlines some of the central challenges being encountered as the pilots get under way.
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This paper aims to present a digest of the main discussion points and key findings from a recent Social Care Institute for Excellence report on risk enablement and safeguarding in…
Abstract
Purpose
This paper aims to present a digest of the main discussion points and key findings from a recent Social Care Institute for Excellence report on risk enablement and safeguarding in the context of self‐directed support and personal budgets.
Design/methodology/approach
The paper explores how the personalisation agenda and adult safeguarding can work together in policy and practice and addresses some of the frontline concerns about empowerment and duty of care.
Findings
Evidence on how self‐directed support and personal budgets can be used to enable people to take positive risks while staying safe and emerging practice is examined. It suggests that person‐centred working in adult safeguarding, along with the mechanism of self‐directed support planning and outcome review, can support the individual to identify the risks they want to take and those they want to avoid in order to stay safe. It is clear that if frontline practitioners are overly occupied with protecting organisations and individuals from financial abuse, this will impact on the capacity of those practitioners exercising their duty of care at the front line. This means that practitioners are less able to engage with individuals to identify safeguarding issues and enable positive risk taking. Defensive risk management strategies or risk‐averse frontline practice may then result in individuals not being adequately supported to make choices and take control and, therefore, being put at risk. Practitioners need to be supported by local authorities to incorporate safeguarding and risk enablement in their relationship‐based, person‐centred working. Good quality, consistent and trusted relationships and good communication are particularly important for self‐directed support and personal budget schemes.
Originality/value
The use of “risk enablement panels” and “personalisation and safeguarding frameworks” are two ways to address some of the issues in practice.
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In the recent government Comprehensive Spending Review there is a promise of a Green Paper on social care services for disabled and, especially, older people. The platform on…
Abstract
In the recent government Comprehensive Spending Review there is a promise of a Green Paper on social care services for disabled and, especially, older people. The platform on which any new proposals will be built is likely to be heavily influenced by the Government's personalisation agenda for public services. It is timely, therefore, to reflect not only on the strengths but also on the potential pitfalls of a major stream, self‐directed support, for the personalisation agenda in adult social care. Anticipating and guarding against unintended consequences of policy are as important as championing the positive opportunities promoted by the policy.
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Susan Hunter, Jill Manthorpe, Julie Ridley, Michelle Cornes and Ann Rosengard
This paper aims to explore the possible connections between self‐directed support and adult support and protection, both of which are important policy developments in Scotland.
Abstract
Purpose
This paper aims to explore the possible connections between self‐directed support and adult support and protection, both of which are important policy developments in Scotland.
Design/methodology/approach
The authors draw on findings from the national evaluation of the test sites or pilots of self‐directed support in Scotland and interviews at two time points with adult protection leads in the test sites. These interview data are set in the context of Scottish developments in adult support and protection.
Findings
Self‐directed support and adult protection had not been joined up initially. In the three Scottish test sites those responsible for adult safeguarding had not been engaged with the changes. They were unclear about the new systems and were concerned about the implications of reduced monitoring of risks. Shared training between those implementing self‐directed support and those carrying out adult protection work was viewed as a way of bridging these different areas of practice through enhancing mutual understanding and communication.
Originality/value
Policy and legislation have used the word support to provide reassurance of social protection for adults in need of care services. This paper provides new opportunities to consider the ways in which early enthusiasm for self‐directed support in Scotland may have neglected the support inherent to support and protection and the ways in which some adult support and protection stakeholders seemed to be acting as “bystanders” rather than influencing new systems of self‐directed support.
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This article outlines the idea of an individual budget, which is now being promoted and tested by central government. It defines the idea, and describes the practical and policy…
Abstract
This article outlines the idea of an individual budget, which is now being promoted and tested by central government. It defines the idea, and describes the practical and policy consequences that may flow from its implementation. It also sets out some of the policy choices that will necessarily emerge from these developments. This article follows on from the earlier article in JIC (February 2005), which was the first article ever published on the subject.
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